DME Fraud

Durable Medical Equipment (DME) fraud remains a cornerstone of federal enforcement as seen in the recent takedown. An indictment in the Western District of New York charges a medical doctor with billing roughly $29.6 million for fictious DME and $5.6 million for audio-only telehealth visits, which were brief or never occurred. That doctor produced and maintained false and fictitious medical records and fraudulently certified orders for braces without regard to medical necessity. The doctor now faces federal criminal charges of conspiracy to commit health care fraud, health care fraud, and false statements relating to health care matters.

In “Operation Gold Rush,” prosecutors in the Eastern District of New York indicted 11 defendants, including two pharmacists, members of a transnational criminal organization based in Russia and Eastern Europe. These individuals allegedly orchestrated a massive Medicare fraud and money-laundering scheme that billed over $10.6 billion to federal health programs—making it the largest case by loss amount ever charged by the DOJ. The group used foreign straw owners to acquire dozens of U.S.-based DME suppliers, then submitted fraudulent claims for equipment such as urinary catheters and glucose monitors that never delivered, exploiting stolen identities and confidential patient data. To date, 19 defendants have been charged in the case, including multiple arrests abroad (Estonia) and at U.S. entry points.

COVID-19 Testing Kickbacks

COVID-19 testing kickback schemes typically involve health care providers or marketers billing Medicare for over-the-counter or lab-based COVID-19 tests that were unnecessary, never provided, or obtained through illicit referrals. These cases often rely on the same core tactics as DME fraud: using stolen or misused patient information, paying illegal kickbacks for referrals, and submitting inflated or false claims to federal programs. In both types of fraud, the perpetrators exploit gaps in oversight during high-demand periods—such as the pandemic or public health emergencies—to rapidly bill large amounts to Medicare, often with little or no patient interaction or verification.

These 2025 takedown includes criminal indictments and civil settlement agreements targeting this type of COVID-19 fraud. An indictment out of Illinois charged multiple individuals, including a physician, for their roles in a kickback scheme. According to the indictment, the defendants caused laboratories in Illinois and Texas to submit fraudulent claims to the HRSA COVID-19 Uninsured Program, ultimately receiving over $293 million in payments. The physician involved allegedly misused patient information—including data from a former hospital employer—to falsely claim that uninsured individuals had submitted samples for COVID-19 testing. In reality, many of the patients had not submitted samples at all. Defendants submitted claims through Texas labs they owned, despite those labs being non-operational. The proceeds were then laundered through various financial accounts to disguise the funds’ origin. Charges include wire fraud, conspiracy to commit money laundering, HIPAA violations, and conspiracy to defraud the United States. Authorities have seized a Rolls Royce Phantom and more than $104 million in assets linked to the fraud.

The charges being brought by the federal government in these cases carry significant criminal penalties and collateral consequences, especially for licensed medical professionals. At Conaway & Strickler, we are highly experienced in defending against these types of claims. Contact us to schedule a consultation and discuss your case.

• Wire fraud
• Mail fraud
• Bank fraud
• Tax fraud (tax evasion or false statements)
• Healthcare fraud/FCA
• Medicare/Medicaid fraud
• PPP loan or COVID relief fraud
• Securities fraud
• Mortgage fraud
• Immigration or visa fraud
• Government contract fraud
• Identity theft or benefits fraud
• Trafficking in Counterfeit Goods or Services
• Anti kickbacks
• AML

The FBI gives this list of frauds and the DOJ publishes some of their cases here.

Fraud investigations can begin in a number of ways. In many cases, they are triggered by:

• A whistleblower or former employee
• A suspicious activity report
• A suspicious activity report (SAR) from a bank or financial institution
• Data flagged by automated fraud detection software
• A referral from another federal agency (e.g., IRS, SBA, USPS, HHS)
• A civil audit or regulatory review that uncovers irregularities
• Investigative journalism or public tips
• Problems in real estate transactions.  (FINCEN’s new rule extends Anti-Money Laundering (AML) and Countering the Financing of Terrorism (CFT) obligations to investment advisers involved in these transactions)

Once red flags are detected, the matter is referred to a federal investigative agency. These can include:

• Federal Bureau of Investigation (FBI)
• Internal Revenue Service – Criminal Investigation (IRS-CI)
• Office of Inspector General (OIG)
• Postal Inspection Service (USPIS)
• Securities and Exchange Commission (SEC)
• Health and Human Services (HHS)
• Small Business Administration (SBA)

If you have been contacted by federal agents FOR ANY REASON, contact a federal criminal defense attorney immediately.  Do not speak period.  If you have received a grand jury subpoena, contact a federal criminal defense attorney immediately.  If you have received a target letter, contact a federal criminal defense attorney immediately.  If you are being audited by the IRS, SBA, HHS or another agency, contact a federal criminal defense attorney immediately. It never hurts in this  last instance to have sage advice before the investigation goes any further.

At Conaway & Strickler, PC, we are here to help. Contact us to discuss your options.

Experienced federal criminal defense attorneys like those at Conaway & Strickler, PC may suggest early on about the possibility of entering into a “deferred prosecution agreement” which is essentially a contract with the Department of Justice. DPAs are frequently used in cases involving corporate fraud, bribery, and antitrust violations.  These pretrial agreements may involve an admission of wrongdoing, the payment of fines, and the implementation of compliance measures.  Charges may be dropped if the defendant complies with the requirements of the agreement.  Generally, the Assistant United States Attorney will file the criminal complaint and the DPA with the court, so it is of public record. This will be accompanied by a formal request to the court that any prosecution be delayed according to the terms of the DPA, allowing the defendant to fulfill its agreed-upon actions.  This is very similar to conditional discharge / pre trial diversion agreements found at the state level.

An example of a DPA would be one that was entered in to by the DOJ and Teva Pharmaceuticals USA, Inc in August 2023 in response to the company’s involvement in a price fixing conspiracy involving several pharmaceuticals.   As seen in this example, terms can include paying a fine, waiving certain rights, agreeing to a factual basis for the charges, and an agreement to cooperate and compliance monitoring and of course, agreeing to what will happen if there is a breach of the agreement.

The central benefit to entering in to a DPA is that the individual or business entity is not convicted of any crime. It offers an opportunity to have the federal criminal charges dismissed or dropped once the accused completes all the required conditions.

Here is an another example of a DPA entered in to with the NDGA and Avanir Pharmaceuticals.  This pharmaceutical manufacturer based in Aliso Viejo, California, was charged for paying kickbacks to a physician to induce prescriptions of its drug Nuedexta.   Of note in that case – the Northern District of Ohio indicted four individuals, including former Avanir employees and one of the top prescribers of Nuedexta in the country, who were involved in the kickback scheme.  So, the company itself entered in to a DPA but there was still fall out with respect to some individuals and receiving criminal indictments.

Early intervention is key in a successful resolution in health care criminal matters.  We have extensively blogged about health care fraud.   Contact us if you need an experienced federal criminal defense litigator.  Our firm has vast experience in white collar criminal investigations including False Claims Act and antitrust investigations.

What reports are generated from my devices?

Cellebrite reports provide information about phone calls and text messages; but now it also provides a report on the data stored on these devices such as voicemails, images, and browsing history. From GPS location data to social media activity, cell phones can provide a treasure trove for law enforcement agencies to use to build their cases.

What protections do I have to prevent law enforcement from searching my devices?

Laws on the admission and use of this evidence in court are still evolving. In the Georgia Supreme Court case State v. Wilson, the court ruled search warrants for cell phone contents must specify the items being sought. This is to prevent a general search of a person’s belongings, which is prohibited by the Fourth Amendment.

Do I have the same legal rights at the border that I would elsewhere in the United States?

The Supreme Court ruled that the police must get a warrant before searching someone’s cell phone in Riley v. California. The Supreme Court held that a warrant is generally required before a search of a cell phone seized incident to arrest. BUT, at the border, there is less protection. According to US Customs and Border Protection a person may be chosen for inspection for many different random reasons and thus there is less protections when crossing the border in or out of the US. What this means – you can be pulled for a secondary inspection and all of your devices can be searched without a warrant. They can also get an image from the hard drive of these devices and / or seize the devices at the border.

What do I do if I am asked to give my cell phone to law enforcement?

If you know your rights, you can comply when necessary. So, for example, if you are traveling internationally – do not travel with devices that you would not want searched. Furthermore, if you are driving and pulled over with drugs or a high amount of currency in your car, etc, your cell phone and / or other devices WILL be seized and analyzed.

And, please remember anything uploaded to the cloud is fair game for law enforcement. That’s a broad statement – but when you signed up for Instagram, Whats App, Google, TikTok, Facebook, Signal, Twitter/X, etc, you signed away any privacy rights. Those companies are fast to comply with law enforcement subpoenas giving whatever you posted/uploaded immediately to them.

Airports are high security environments with strict rules enforced through law enforcement, federal agents, TSA checkpoints, drug-sniffing dogs, US Marshals aboard flights, and more. Being arrested at an airport is overwhelming, scary, and often times, completely unexpected. However, the consequences of these arrest can be serious and long-lasting. An arrest at an airport could lead to detention by law enforcement, criminal charges, and the need to retain legal representation.

If you are arrested at an airport, you may be taken into custody and transported to a detention center or police station where you will be held and processed until further legal proceedings. However, this does not always happen at the airport – you may leave the airport and later have a warrant issued for your arrest. In that case, you would still need to turn yourself in for processing with law enforcement. In either circumstance, it is essential to remember your rights, including the right to remain silent and the right to legal counsel. Contacting an experienced criminal defense attorney will help you navigate that distressing process with an advocate by your side.

Airport arrests can lead to severe criminal charges depending on the circumstances of your case. Common criminal charges in this context cover a broad range including drug offenses, sexual offenses, firearm offenses, DUIs, disorderly conduct, battery, theft, trafficking, and fraud. You could also be arrested at the airport for entirely unrelated criminal charges if you are simply identified and apprehended pursuant to an active arrest warrant, such as this recent arrest in Atlanta. Committing crimes while aboard an aircraft (like interfering with the performance of the duties of a flight crew) can lead to federal criminal charges and even more severe penalties. Many of these charges carry significant terms of imprisonment and hefty fines.

A strong legal defense is crucial if you have been arrested at an airport or are under investigation for alleged conduct at an airport. A skilled criminal defense attorney will guide you through the process, explain the charges against you, and evaluate the evidence to develop a defense strategy tailored to your case.

At Conaway and Strickler, we craft a defense based on the unique circumstances of each case and work closely with our clients to pursue favorable resolutions. If you have been arrested or detained at an airport, it is important to hire an attorney that is experienced in this area of law and can safeguard your rights throughout each step of the process. Contact us for a free consultation regarding your case.

In deciding whether to terminate probation early, the Court will consider the factors set forth in 18 U.S.C. 3553(a). The 3553(a) factors include: the nature and circumstances of the offense, the history and characteristics of the defendant, the need for the sentence imposed to reflect the seriousness of the offense, to promote respect for the law, and to provide just punishment for the offense, the need for the sentence imposed to afford adequate deterrence to criminal conduct, the need for the sentence imposed to protect the public from further crimes of the defendant, the need for the sentence imposed to provide the defendant with needed educational or vocational training, medical care, or other correctional treatment, and the need for the sentence imposed to avoid unwarranted sentence disparities among defendants with similar records who have been found guilty of similar conduct.

After a defendant files a petition to have their sentence modified or terminated, it is the Judge’s decision whether probation should be terminated early. This judge will often be the same judge that imposed the original sentence. In most cases, judges deny requests; however, certain factors can strengthen a defendant’s request for early termination of probation. Overall, to successfully terminate a term of probation, the defendant must show that they have earned it through good conduct, and it would be in the interests of justice.

Judges may consider the following factors in their determination of a request to terminate or modify the term of probation:

• Whether your probation officer and the Prosecutor support your request;
• The nature and seriousness of the crime you were convicted of;
• Your criminal history and/or mental illness history;
• Whether the judge believes you are a threat to the public;
• Whether the judge believes you have been sufficiently punished;
• Whether you have completed any substance abuse treatment or rehabilitation programs;
• How your sentence compares to the federal sentencing guidelines recommended sentence;
• U. S. Sentencing Commission policy statements;
• Whether you’ve paid restitution to the victims.

Under proposed USSG 4C1.1, a client will receive a 2-level decrease to their offense level if a)no criminal history points,

b)did not receive a terrorism adjustment under §3A1.4

c)did not use violence or threats of violence,

d) did not cause death or serious injury,

e) did not commit a sex offense,

f) did not cause any victim substantial financial hardship,

g) did not possess or use a firearm or deadly weapon,

h) did not violate a victim’s civil rights,

i) did not commit a hate crime, an adjustment under §3A1.1 , and

j) did not receive an aggravating role adjustment pursuant to Chapter 3 of the USSG.

Also, another related amendment provides in Application Note 4 (A) to §5C1.1 “that a sentence other than imprisonment is generally appropriate” for a client in Zone A or B after a §4C1.1 reduction

Under proposed USSG 5C1.1, a non-custodial sentence is “generally appropriate” for a Zero-Point Offender in Zone A or B of the Sentencing Table. For reference, the highest range for a Zero-Point offender in Zone B is 8-14 months imprisonment. For Zero-Point offenders outside of Zone A and B, however, subsection (b) to 5C1.1 suggests a downward departure, including to probation, for Zero-point offenders if the applicable Guidelines range “overstates the gravity of the offense because the offense of conviction is not a crime of violence or an otherwise serious offense.”

Long and short, there is a more of a possibility to get probation in less complex fraud cases now.

Contact contact us to get more details.

It’s a Federal crime to commit aggravated identity theft.

The Defendant can be found guilty of aggravated identity theft only if all the following facts are proved beyond a reasonable doubt:

(1) the Defendant knowingly transferred, possessed, or used another person’s [means of identification] [identification documents];

(2) without lawful authority; and

(3) during and in relation to [the eligible felony alleged in the indictment].

[A “means of identification” is any name or number used, alone or together with any other information, to identify a specific person, including a name, social security number, date of birth, officially issued driver’s license or identification number, alien registration number, passport number, employer or taxpayer identification number, or electronic identification number or routing code. It can also include a fingerprint, voice print or other biometric data.]

[An “identification document” is a document made or issued by or for the United States Government, a state or foreign government or political subdivision.]

The Government must prove that the Defendant knew that the [means of identification] [identification documents], in fact, belonged to another actual person, [living or dead,] and not a fictitious person.

The Government must prove that the Defendant knowingly transferred, possessed, or used another person’s identity “without lawful authority.” The Government does not have to prove that the Defendant stole the [means of identification] [identification documents]. The Government is required to prove the Defendant transferred, possessed, or used the other person’s [means of identification] [identification documents] for an unlawful or illegitimate purpose.

The Government also must prove that the [means of identification] [identification document] was possessed “during and in relation to” the crime alleged in the indictment. The phrase “during and in relation to” means that there must be a firm connection between the Defendant, the [means of identification] [identification documents], and the crime alleged in the indictment. The [means of identification] [identification documents] must have helped with some important function or purpose of the crime, and not simply have been there accidentally or coincidentally. The [means of identification] [identification documents] at least must facilitate, or have the potential of facilitating, the crime alleged in the indictment.

We at Conaway & Strickler, PC know how to combat these type of charges. Please feel free to access our blog for other entries here

Please contact us to learn more should you be facing criminal charges.